| NPI | 1285393538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 12090) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 66203) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 12090) | |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2026-07-30 |